# ROCKY MOUNT REHABILITATION CENTER, LLC

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- **Entity:** Organization
- **Status:** Active
- **Other names:** Rocky Mount Rehabilitation Center
- **Organization subpart:** No

## Provider details

- **NPI number:** 1205252640
- **Authorized official:** MR. R. MARK CRONQUIST (MANAGER)
- **Authorized official phone:** (404) 574-2100

## Contact information

- **Practice address:** 160 S WINSTEAD AVE, ROCKY MOUNT, NC 27804-3419
- **Practice address phone:** (252) 443-7666
- **Practice address fax:** (252) 443-2915
- **Mailing address:** 5887 GLENRIDGE DR, SUITE 150, ATLANTA, GA 30328-5574
- **Mailing address phone:** (404) 574-2100
- **Mailing address fax:** (404) 574-2105

## Taxonomy

| Code | Description | License number | State | Primary |
| --- | --- | --- | --- | --- |
| 314000000X | Skilled Nursing Facility | NH0313 | NC | Yes |
| 314000000X | Skilled Nursing Facility | — | NULL | — |

## Other

- **Enumeration date:** 03/10/2014
- **Last updated:** 09/29/2014

## Other identifiers

| Code | Description | Identifier | Issuer | State |
| --- | --- | --- | --- | --- |
| 05 | — | 1205252640 | — | NC |